The carbon footprint of cataract surgery pathways in England: an observational study using administrative data

The National Health Service (NHS) in England has set a target to be net zero for carbon emissions by 2045. The aim of this study was to investigate the estimated difference between the carbon footprint of the Getting It Right First Time (GIRFT) High Volume Low Complexity (HVLC) pathway for cataract surgery and current practice.

Retrospective analysis of administrative data. Data were extracted from the Hospital Episode Statistics database for all elective cataract surgery procedures conducted in England from 1st April 2021 to 31st March 2022.

The England average carbon footprint was 100.0 kgCO₂e (ranging from 74.8 kgCO₂e - 128.0 kgCO₂e depending on Integrated Care Board). Had all Integrated Care Boards adhered to the GIRFT HVLC pathway, then 17.5 kilotonsCO₂e would have been saved in 2021-22. The main limitation of our study is that only key elements of the cataract surgery pathway were included in the analysis.

Even in a standardised healthcare pathway such as cataract surgery and within a publicly funded national healthcare system, significant differences in practice exist. With this paper we have demonstrated that tackling this unwarranted variation and adhering to the GIRFT HVLC pathway where possible has the potential to reduce the carbon footprint of cataract surgery.